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. 2022:8:14.
doi: 10.1051/sicotj/2022014. Epub 2022 Apr 6.

The correlation between clinical and radiological severity of osteoarthritis of the knee

Wynand Steenkamp  1 , Pududu Archie Rachuene  1 , Roopam Dey  2 , Nkosiphendule Lindani Mzayiya  1 , Brian Emmanuel Ramasuvha  1
Affiliations

The correlation between clinical and radiological severity of osteoarthritis of the knee

Wynand Steenkamp et al. SICOT J. 2022.

Abstract

Introduction: Primary osteoarthritis (OA) is a common cause of knee pain. Appropriate management of knee OA is based on clinical and radiological findings. Pain, deformity, and functional impairments are major clinical factors considered along with radiological findings when making management decisions. Differences in management strategies might exist due to clinical and radiological factors. This study aims at finding possible associations between clinical and radiological observations.

Methods: A prospective cross-sectional study of 52 patients with primary osteoarthritis of the knee managed conservatively at a tertiary hospital arthroplasty clinic was conducted for three months. English speaking patients with primary OA were identified and included in this study. Pain and functional impairment were assessed using Wong-Baker Faces pain scale, The Knee Society Score (KSS), and Western Ontario and McMaster Osteoarthritis Index (WOMAC). The Body Mass Index (BMI) of all participants was measured. Standard two views plain radiographs were used for radiographic grading of the OA. Anonymized radiographs were presented to two senior consultant orthopaedic surgeons who graded the OA using Kellgren and Lawrence (KL) and Ahlbäck classification systems. The severity of the functional impairment and pain score was then compared to the radiological grading.

Results: The average age of our participants was 63 ± 9 years. Their average BMI was 34.9 ± 8.4 kg/m2, median self-reported pain, total WOMAC, and pain WOMAC scores were 8, 60, and 13, respectively. We observed no significant correlation between BMI and pain scores. Inter-rater reliability for KL and Ahlbäck grading was strong. There was no significant correlation between WOMAC scores and the radiological grades.

Conclusion: There was no correlation between pain and functional scores, patient factors and radiological severity of OA of the knee.

Keywords: Functional impairment; Knee; Osteoarthritis; Radiologic grading.

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Figures

Figure 1
Figure 1
Patient self-reported pain score plotted against their BMI, and their linear relationship is shown by the red dashed trend line.
Figure 2
Figure 2
Patient WOMAC score plotted against their BMI, and their linear relationship is shown by the black dashed trend line.
Figure 3
Figure 3
Patient Knee Society score plotted against their BMI, and their linear relationship is shown by the green dashed trend line.
Figure 4
Figure 4
Patient Kellgren and Lawrence radiological grading plotted against their BMI, and their linear relationship is shown by the blue dashed line.
Figure 5
Figure 5
Patient Ahlbäck radiological grading plotted against their BMI, and their linear relationship is shown by the blue dashed line.
Figure 6
Figure 6
Patient WOMAC score components plotted against their Knee Society Scores (KSS). Total WOMAC score is represented by the blue color, the Pain component is represented by the orange color, the Functional component is represented by the black color, and the Stiffness component is represented by the purple color. Each component’s linear relationship with KSS is represented by the dashed in their respective colors.
Figure 7
Figure 7
Patient Ahlbäck radiological grades plotted against Kellgren and Lawrence’s radiological grades, and their linear relationship is shown by the blue dashed line.
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